Cost-effectiveness of an internet-based booster program for patients with obsessive–compulsive disorder: Results from a randomized controlled trial

•Many OCD patients relapse after reciveing CBT.•Booster programs have been showing some promising results to reduce relapse but there are no health economical evaluations of these interventions. This study therefore set out to investigate the cost-effectiveness of an internet-based booster program.•Results showed that the price of one avoided relapse was estimated to $1066–1489.•Internet-based booster programs are probably cost-effective.

Cognitive behavior therapy (CBT) is an effective treatment for OCD when delivered face-to-face, in group-format and also via the internet. However, despite overall large effect sizes, a considerable amount of the patients relapse. One intervention that has the potential to reduce these relapse rates is booster programs, but if booster program is a cost-effective method of preventing relapse is still unknown. We used health economical data from a recent randomized controlled trial, where patients who had undergone an internet-based CBT were randomly allocated to receive an additional booster program. Assessment points were 4-, 7-, 12- and 24-month. Health economical data were primarily analyzed using a societal perspective. Results showed that the booster program was effective in preventing relapse, and the cost of one avoided relapse was estimated to $1066–1489. Cost-effectiveness acceptability curves showed that the booster program had a 90% probability of being cost-effective given a willingness to pay of $1000–1050 the first year, but this figure grew considerably after two years ($2500–5500). We conclude that internet-based booster programs are probably a cost-effective alternative within one-year time frame and that more treatment may be needed to maintain adequate cost-effectiveness up to two years.